<!DOCTYPE html>
<html>
<head>
    <meta charset="utf-8">
    <title>layui</title>
    <meta name="renderer" content="webkit">
    <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
    <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1">
    <link rel="stylesheet" href="../../lib/layui-v2.5.5/css/layui.css" media="all">
    <link rel="stylesheet" href="../../css/public.css" media="all">
    <link rel="stylesheet" href="../../css/common.css">
</head>
<body>
<input type="hidden" name="sellerId">
<input type="hidden" name="serviceId">
<input type="hidden" name="orderId">
<input type="hidden" name="orderSource">

<script src="../../lib/layui-v2.5.5/layui.js" charset="utf-8"></script>


<div class="layuimini-container">
    <div class="layuimini-main">
        <div class="ui_box">
            <div class="ui_tit">发票申请</div>

            <table class="ui_fatit">
                <tbody><tr>
                    <td style="border: 0;">
                    </td>
                    <td style="border: 0;" align="center">
                        <span class="ui_l" style="line-height:32px;">
                            <select class="ui_fpClass">
                                <option value="0">增值税专用发票</option>
                                <option value="1">增值税普通发票</option>
                            </select>
                        </span>
                        <div class="ui_line"></div>
                        <p class="ui_fatext">发 票 联</p>
                    </td>
                    <td class="ui_h" align="right" style="border: 0;">申请日期：<span class="ui_l applyTime"></span></td>
                </tr>
                </tbody></table>
            <table width="100%" border="0" cellspacing="0" cellpadding="0" class="ui_fa1">
                <tbody><tr>
                    <td rowspan="4" width="30px" style=" border-bottom: 0;">购买方</td>
                    <td style="padding-left: 15px;" width="150">名 &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;　称：</td>
                    <td>
                        <p class="ui_l" id="gmf"></p>
                    </td>
                    <td rowspan="4" width="30px" style=" border-bottom: 0;">收件人</td>
                    <td style="padding-left: 15px;" width="130">姓 &nbsp;&nbsp;　名：</td>
                    <td>

                        <div class="styled-select1" style="float: left;">
                            <select onchange="iExpress(this);" id="expressId" style="color: #3160d8;">
                                <option value="|||">请选择收件人</option>
                            </select>
                        </div>
                        <div style="padding:4px 0 0 10px; margin-left: 232px;">
                            <a href="javascript:;" class="addAdse" style="padding: 5px 15px; border-radius: 5px;
                             background: #1E9FFF; color: #fff; cursor: pointer;">新增</a></div>

                    </td>
                </tr>
                <tr>
                    <td style="padding-left: 15px;">纳税人识别号：</td>
                    <td><input type="text" id="sh" style="color: #3160d8;  background: #ffffff;" disabled value=""></td>
                    <td style="padding-left: 15px;">手 机 号：</td>
                    <td><input type="text" id="sjh" disabled style="color: #3160d8; background: #ffffff;"></td>
                </tr>
                <tr>
                    <td style="padding-left: 15px;">地 址、电 话：</td>
                    <td><input type="text" id="dz" disabled style="color: #3160d8;  background: #ffffff;" value=""></td>
                    <td style="padding-left: 15px;">收件地址：</td>
                    <td><input type="text" id="sjdz" disabled style="color: #3160d8; background: #ffffff;"></td>
                </tr>
                <tr>
                    <td style="padding-left: 15px; border-bottom: 0;">开户行及账号</td>
                    <td style=" border-bottom: 0;"><input type="text" id="yh" disabled style="color: #3160d8;  background: #ffffff;" value=""></td>
                    <td style=" border-bottom: 0;">&nbsp;</td>
                    <td style=" border-bottom: 0;">&nbsp;</td>
                </tr>
                </tbody></table>
            <table width="100%" border="0" cellspacing="0" cellpadding="0" class="ui_fa1">
                <tbody><tr align="center">
                    <td>货物或应税劳务、服务名称</td>
                    <td colspan="3">金额（元）</td>

                </tr>
                <tr height="120" valign="top">
                    <td valign="middle" style="color: #3160d8;" id="role_id">

                        <label class="ui-flex" style="  padding:10px 0;cursor: pointer;text-align: left;">
                            <div style="padding:14px 10px 0 0;"><input type="radio" name="invoiceContent" style="width: auto;" value="生活服务*文化服务"></div>
                            <div>
                                <b>文化服务</b>
                                <p style="padding-top:4px;">生活服务</p>
                            </div>
                        </label>

                    </td>
                    <td valign="middle" colspan="3" align="center"><span class="ui_l"><input type="text" id="invoiceAmount" maxlength="12" lay-verify="number" style="border-bottom: 1px solid #3160d8; height: 59px; width: 90%; color: #3160d8;" onkeyup="money(this);" data-amount="" autocomplete="off"></span> </td>
                </tr>
                <tr>
                    <td align="center">价 税 合 计（大 写）</td>
                    <td width="30%"><span class="ui_l ">￥<span class="dxje">零元整</span></span></td>
                    <td width="20%" style="border-left: 1px solid #fff;">（小写）<span class="ui_l xxje">￥</span></td>
                </tr>
                </tbody></table>
            <table width="100%" border="0" cellspacing="0" cellpadding="0" class="ui_fa1">
                <tbody>
                <tr>
                    <td rowspan="4" width="30px" style=" border-bottom: 0;">销售方</td>
                    <td style="padding-left: 15px;" width="150">名 &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;　称：</td>
                    <td>
                        <p class="ui_l" id="xsf">芜湖金智信息科技服务有限责任公司</p>
                    </td>
                </tr>
                <tr>
                    <td style="padding-left: 15px;">纳税人识别号：</td>
                    <td><span class="ui_l" id="tax">91340223MA2TPWCR8J</span></td>
                </tr>
                <tr>
                    <td style="padding-left: 15px;">地 址、电 话：</td>
                    <td>
                        <p class="ui_l" id="dzdh">18621783111</p>
                    </td>
                </tr>
                <tr>
                    <td style="padding-left: 15px; border-bottom: 0;">开户行及账号</td>
                    <td style=" border-bottom: 0;">
                        <p class="ui_l" id="cyh">工商银行芜湖南陵支行-1307026019200044202</p>
                    </td>
                </tr>
                </tbody>
            </table>
            <table class="ui_fa1" width="100%" height="80">
                <tbody><tr>
                    <td width="65" style="border-right: 0; color: #be8f00;"> </td>
                    <td align="center" style="border-left: 0;"><button type="button" class="layui-btn layui-btn-normal" id="submitBtn">提 交</button></td>
                </tr>
                </tbody></table>
        </div>
    </div>
</div>
<script src="../../js/invoice/applyInfo.js"></script>


</body>
</html>